Non-Profit Sets New Standards For Modular EHRs

The Massachusetts eHealth Collaborative made new strides for modular electronic health records this month after achieving all three Meaningful Use Stage 2 requirements for its in-house-built EHR module.

The non-profit health IT organization (MAeHC) created a modular EHR for clinical quality measurements reporting, which the Certification Commission for Health Information Technology certified to support Meaningful Use Stage 2. The cloud-hosted software is meant to integrate with stand-alone EHRs and can span across multiple EHR platforms, allowing multiple organizations to work together on care coordination using different systems.

MAeHC needed to meet one of three criteria to qualify for Meaningful Use Stage 2: capture and export, import and calculate, and electronic submission.

One of the challenges for certification was in interpreting the definitions that make up the criteria. The first criteria, capture and export, require EHRs to electronically record data and export it following established standards. Because MAeHC's EHR is modular, there is no user interface to manually key in data.

"The EHR certification criteria are not always as operational as we'd all like them to be," MAeHC project director Dave Delano said. "Since we were relatively early out of the gates in terms of testing modular EHRs for clinical quality measures (CQMs), there was still a lot of work to do to translate the certification standards into practical testing protocols. Working with terrific assistance from CCHIT, we were able to accomplish that in a way that will hopefully make it more streamlined and operationally relevant for others who go down this path."

To meet the criteria, modular EHRs must use the Quality Reporting Document Architecture Type 1 document to capture and input the data electronically, effectively standardizing the capture process for Meaningful Use-certified modular EHRs. The system is certified for eligible providers and is expected to be certified for eligible hospitals within the next few weeks.

MAeHC wanted to meet all three criteria to broaden the scope of the services it offers. Those services are available to more than 2,500 providers, which can create a headache when aligning coding practices.

"The challenge is not so much Meaningful Use," Delano said. "The biggest challenge is alignment of what's expected for the results to be generated and what we actually receive from the EHR vendors. We're trying to re-shift the coding practices of providers and hospitals to align with what the CQM measure specifications are looking for."

The modular EHR is not able to cross-map the codes the same way a native EHR would. "There's a broadening disconnect with what the codes are for 2014 Stage 2 CQMs against what's actually being used currently and sent from the organizations we're working with," Delano explained. "A lot of evolutionary work has to happen to make sure these things align correctly and get meaningful CQM results."